本文關(guān)鍵詞： 胚胎冷凍 分裂胚 囊胚 種植率 流產(chǎn)率 多胎率　出處：《臨床和實驗醫(yī)學(xué)雜志》2016年24期 　論文類型：期刊論文

【摘要】：目的比較凍胚移植周期低等級囊胚與不同質(zhì)量分裂胚凍融移植后的妊娠結(jié)局,探討不同時期和質(zhì)量的胚胎的發(fā)育潛能,為臨床凍融周期移植胚胎的選擇策略提供參考。方法回顧性分析2015年1月至2016年6月凍胚移植周期患者臨床資料,將同一新鮮周期中既有第三天冷凍分裂胚又在第五天僅有低等級囊胚冷凍者納入研究。其中冷凍的分裂胚按照形態(tài)學(xué)評分標(biāo)準(zhǔn)分為頂級冷凍分裂胚和次級冷凍分裂胚�；颊咦栽高x擇分裂胚或第5天囊胚解凍,移植2枚胚胎。移植胚胎均為低等級囊胚者243周期,移植胚胎均為頂級分裂胚者156周期,移植胚胎均為次級分裂胚者114周期。比較三組胚胎的臨床妊娠率、種植率、早期流產(chǎn)率和多胎率,進(jìn)行統(tǒng)計學(xué)分析。結(jié)果頂級分裂胚與低等級囊胚的臨床妊娠率和種植率相似(64.20%vs.64.74%,44.03%vs.46.79%),顯著高于次級分裂胚(49.12%,35.48%);頂級分裂胚的早期流產(chǎn)率顯著低于低等級囊胚和次級分裂胚(3.96%vs.8.33%,7.14%);多胎率方面,頂級分裂胚最高(44.55%),其次為低等級囊胚(37.18%)和次級分裂胚(32.46%),但流產(chǎn)率和多胎率的差異無統(tǒng)計學(xué)意義。結(jié)論凍胚移植周期中,頂級分裂胚與低等級囊胚相比,具有更好的妊娠結(jié)局,次級分裂胚的臨床結(jié)局較差。當(dāng)患者冷凍的囊胚只有低等級,而同時有分裂胚冷凍時,首選頂級分裂胚進(jìn)行解凍和移植,其次為囊胚,最后為次級分裂胚。
[Abstract]:Objective to compare the pregnancy outcomes of frozen-thawed embryos with low-grade blastocysts and cleavage embryos of different quality in order to explore the developmental potential of embryos of different stages and quality. Methods the clinical data of patients with frozen embryo transfer cycle from January 2015 to June 2016 were retrospectively analyzed. The cryopreserved blastocysts of the same fresh cycle were divided into two groups according to the morphological score: the top frozen cleavage embryo and the second frozen blastocyst according to the morphological scoring criteria, and the cryopreserved blastocysts were only cryopreserved on the third day and only on the 5th day. Cleavage embryo. The patient voluntarily chooses to divide the embryo or thaw the blastocyst on the 5th day. Two embryos were transferred. 243 cycles of low-grade blastocysts, 156 cycles of top cleavage embryos and 114 cycles of secondary cleavage embryos were transferred. The clinical pregnancy rate and implantation rate of the three groups were compared. Early abortion and multiple births, Results the clinical pregnancy rate and implantation rate of the top and low grade blastocysts were similar to those of the top and low grade blastocysts. Results the clinical pregnancy rate and implantation rate of the top and lower grade blastocysts were similar to those of the top cleavage embryos, which were significantly higher than those of the secondary cleavage embryos. The early abortion rate of the top cleavage embryos was significantly lower than that of the lower grade blastocysts and the secondary division blastocysts 3.96vs.8.337.14.The rate of multiple births was significantly higher than that of the second grade blastocysts. The highest cleavage embryo was 44.55g, followed by the lower grade blastocyst (37.18) and the secondary division embryo (32.46), but there was no significant difference between the abortion rate and the multiple embryo rate. Conclusion in the frozen embryo transfer cycle, the top division embryo has a better pregnancy outcome than the low grade blastocyst. When the cryopreserved blastocysts were only of low grade and the cleavage embryos were frozen at the same time, the first choice was thawing and transplanting, the second was blastocyst, and the last was secondary cleavage embryo.
【作者單位】： 江蘇省南京市南京大學(xué)醫(yī)學(xué)院附屬鼓樓醫(yī)院生殖醫(yī)學(xué)中心;
【基金】：國家自然科學(xué)基金青年基金項目(編號:81601277) 南京市醫(yī)學(xué)科技發(fā)展課題項目(編號:YKK15074)
【分類號】：R714.8

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